Community Pharmacists and Productivity
Owning a pharmacy can be an expensive proposition. I can
only imagine what it might be like to own 1000 plus pharmacies and try to
manage them. If I were a non-pharmacist and sitting in an office somewhere, I
would want some sort of measurement to gauge how all of my pharmacies were
running. Perhaps I would wonder what my pharmacists did all day with their
tasks, so I may ask them to document each step of their day and enter it into
flow charts. Then I would be in a position to measure each store to the other
to see how productive one store was compared to the other.
Maybe, just maybe, I should visit each store and talk with the pharmacists that work at that site. Perhaps the pharmacists may have some input as to how the store may be staffed and worked to become more patient centered. The pharmacist may have this idea on how the pharmacy could become the medication education center for the town. Perhaps the pharmacist might have the opportunity to spend more time educating the patients on appropriate use and understanding of their medications, and less time filling out flow sheets that document how fast a prescription got filled and how long a patient had to wait for their prescription.
I would like to see a measurement system that records how well a pharmacist counsels their patient. A metric that looks at how well the patient understands what they are going to do with their medications and measures their outcome of therapy based upon the results of the counseling interaction they had with their community pharmacist.
Where I work, we have one measurement we document at the end of each day. We count the number of prescriptions filled during that day. This is by no means a perfect metric; however, the accountants need a number to gauge our productivity. On any given day, we usually meet our metric.
I am taking a moment to discuss this because for some reason
this question has come up a few times recently, “What is it you do in the
pharmacy anyway?”
The other day I took a few moments to try and document the activities of a normal day in the pharmacy.
- 24
times I met patients at the pharmacy counseling station to discuss their
new medication with them, assuring that it did not interact
inappropriately with their current medication profile and that they
understood all the appropriate information about their new medications.
- 5
times doctors called to consult about medication regimens, 3 were for
antibiotic therapy regimens and 2 were for pain medication regimens.
- 3
times I called doctors to discuss a potential drug interaction on a new
medication order.
- 1 time
I called a doctor back to clarify the dosing on a prescription written for
injectable blood thinner medication. The dose was not appropriate for the
patient's weight.
- 3
times I called doctors to clarify prescriptions because the dose that came
through on the electronic prescription was different from the dose we had
filled last time for the patient.
- 1 time
I called a doctor in the Neonatal Intensive Care Unit to clarify the dose that
he wanted us to compound for a newborn being discharged from the hospital.
- I
participated in helping discharge 3 patients from the Behavior Health
Unit, each of which had at least 5 prescription orders, and one of which
had 13 prescription orders.
- I
worked with a Social Worker at the Hospital to help discharge a patient
that had no funds. We helped them receive 48 hours supply of discharge
medications to hold them over until they are able to get to the
county/state resource available to them to complete their prescription
order.
- I
participated in helping fill a Hospice Admission order which includes 9
emergency medications and then counsel the family member on the use of
these medications.
- I
worked with my partner in the store helping to implement a new “real time”
computer narcotic inventory system.
- 14
times I consulted with patients on over the counter concerns relating to
cough, congestion, diarrhea, constipation, itchy eyes, dry mouth and
various other situations.
- Participated
in helping to compound 3 different medications for pediatric patients.
I participated as a member of a team of 2 technicians, 1 pharmacist and 1 pharmacist manager. Together we exceeded our metric of how ever many prescriptions we needed to fill that day to stay positively productive. More than that, we worked as a team to assure that our patients received the best possible pharmacy care we could give them.
Community Pharmacists do fill prescriptions; however, they also know who you are, know your medication profiles, and work behind the scene all day to ensure that patients receive the best medication therapy. Until the point comes that we are able to measure the effectiveness of how a pharmacist provides pharmaceutical care, we will continue to count how many prescriptions we fill each day.
Steve